Ki Byung Chae, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.015072 Issued in IL

Practice address

1823 Hicks Rd Unit a
Rolling Meadows, IL 60008-1270

Phone

(708) 797-3171

NPI assigned

Mar 13, 2019

Last updated

Sep 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Living Counsel LTD.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Inverness, IL
  • NPI 1609305341
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1386103000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 W COLONIAL PKWY STE 202",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600674755",
            "telephone_number": "708-797-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 HICKS RD UNIT A",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600081270",
            "telephone_number": "708-797-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAE",
        "first_name": "KI BYUNG",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.015072",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A12368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Rolling Meadows, IL
• Providers in Rolling Meadows, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.